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Thursday, August 2, 2018

Supremes Enter Healthcare Tug-Of-War

Originally Published March 22, 2012; Last Updated August 02, 2018; Last Republished August 02, 2018:
For reasons that are not immediately apparent our Supreme Court has elected to enter the politically charged healthcare tug-of-war—perhaps as referee for divergent lower court decisions?

It's difficult to imagine a more compelling federal purpose than Congress providing for the welfare of all our citizens by ensuring they are afforded systematic, effective, and competent healthcare.

Disabusing our unstable, unfit, unwell, and unbalanced "new" alt-white-house and Republican Party et al. of the delusional notion that others will rescue them from the efforts to dismember, dismantle, and destroy healthcare for our citizenry is a fools mission!

Where is the Republican Party's politicians promised replacement, which protects our citizenry from losing their current healthcare and adherence to the Republican Party's murky mantra and raison d'etre of passing only "deficit neutral legislation"?

"...The measure would abolish the government’s enforcement of the ACA requirement that most Americans carry insurance coverage. It would not end the individual mandate itself but would eliminate tax penalties for flouting that requirement. The result could cause an extra 13 million people to become uninsured and drive up insurance premiums in marketplaces created under the law, according to an estimate by Congress’s nonpartisan budget analysts.

Yet downstream effects of the bill that have drawn less attention could potentially damage the health care and well-being of far more people.

The Senate plan would increase the federal deficit starting in the current fiscal year and — unless lawmakers intervene — would unleash a budgetary sequence of events cutting billions of dollars from Medicare and public health services. The reductions would flow from a “pay as you go” law that basically requires offsets to increases in federal spending..." --WP, Senate’s massive tax bill would have potent ripple effects for health-care system--

The Republican Party's willingness to opportunistically abandon their murky mantra and raison d'etre is not surprising given they've also been purveyors of economic myths about tax cuts (e.g. tax cuts pay for themselves, increase wages, create jobs, trickle-down to poor, and etc.) for decades, in spite of data belying these myths!

More threats of madness, mayhem and misery from our unstable, unfit, unwell, and unbalanced "new" alt-white-house. It's unclear how creating more madness, misery and mayhem is useful or helpful or results in a tax break for our privileged class? These are the abhorrent tactics of terrorists—destroy what others build until you get what you want!

Our "new" alt-white-house has morphed the Republican Party into the party of madness, misery, and mayhem...only two phone calls should be made the our "new" alt-white-house...one saying "your fired"...the other say "you've been indicted"...

The Republican Party is not just peddling pathetic healthcare legislation it's doing so in a particularly cruel way! When pressed for specifics it spews dogma like a sick parrot—just listen to the pathetic response from GOP representative Pence!

"GOP opposition to Obamacare, punctuated by absurd accusations [aka blatant lies] of death panels, ridiculous narratives about the health-care system collapsing and persistent efforts to undermine coverage expansion for millions, was divorced from fact or reason from the beginning. Now the party is reaching for a new low, forcing through a cruel bill without leveling with Americans or even themselves about what is in it, merely because it has “Obamacare repeal” stamped on it. We could maybe give you 10 reasons why politicians like that do not merit the trust voters have placed in them."--WP--

How about 10 reasons why such a cruelly prevaricating party should never take part in any policy making decisions effecting our nation or citizenry?

If Senator Graham has never felt better than where the Republican Party is on healthcare he needs to visit his doctor. If Graham-Cassidy's stealth efforts to gut current healthcare legislation succeeds millions of our citizenry will lose their healthcare.

If federalist dogma requires that millions of our citizenry lose their healthcare, as Graham implicitly asserts who benefits from adhering to such dogma†?

Another perverse effect of the Graham-Cassidy's stealth legislation is that it would direct healthcare dollars away from states, which speedily implemented healthcare for all their residents to states that spent years chanting "repeal and replace" instead of figuring out how to give their residents healthcare. In short it rewards the Republican Party's dogmatic obstructionists to universal healthcare!

† Evangelists for federalists dogma rarely, if ever support their prophecy and preaching about "local control" with data or facts, Instead they substitute meaningless platitudes about founding fathers, freedom, patriotism, or party loyalty etc.

For example:

setting the timing of a street light is likely best done by a local traffic engineer; determining what colors the street lights use is likely best done nationally;

setting bus schedules for picking up school children is likely best done locally; determining whether to pick up black children for school is likely best done nationally;

[insert any of the millions of issues that require careful analysis and balancing of local and national approaches to ensure optimal solutions].

Dogmatically preaching federalism as a panacea is disingenuous, at best and usually a sham to harmfully perpetuate reactionary local interests (e.g. slavery, polygamy, trafficking, proselytizing, moral purity, sectarianism, and conservatism etc.). When you preach such harmful dogma you tend to become a professional prevaricator when selling it, although usually not so publicly and shamelessly as with healthcare.

Our nation is on an inexorable path to national healthcare. But, every year we see the contortions of our leaders, which enable the insurance and healthcare sectors to squeeze our citizenry for just a little more money for lesser health outcomes, on average.

Shamefully, some of our states' leaders have complained (some might say confessed) that they're unable to give healthcare to their residents, substituting slogans about "freedom to choose" instead of delivering comprehensive healthcare!

This year's contortions include outrageous threats and active sabotage by our "new" alt-white-house to effectively deny comprehensive healthcare to millions of our citizenry!

Inexplicably Senator McCain pleads with colleagues to return to "regular order" before voting yeah (aye) to go ahead with debate on deconstructing the precarious patchwork legislation enabling millions of our citizens to receive comprehensive healthcare, many for the first time.

Senator McCain predicts the Republican Party's healthcare deconstruction effort will and should fail. The Republican Party's harmful and hurtful credo imagines our government must refrain from subsidizing a nonexistent "free healthcare market" when that market fails to profitably offer comprehensive healthcare to millions of our citizens! The kind of healthcare enjoyed by Senator McCain and his colleagues.

Senator McCain could have shortened his eloquent plea by simply saying his Republican Party knows no shame!

Last gasps for life are difficult to watch particularly if they result from lack of comprehensive healthcare!

Senator McCain does not need "prayers" he needs comprehensive healthcare and access to skilled cancer specialists, which he has courtesy of our citizenry. Reprehensively†, our senate is now working hard to deny millions of that citizenry comprehensive healthcare and access to medical specialists!

It's important to realize that promising progress understanding cellular molecular pathways and signaling is not a cancer cure.

† It is beyond reprehensible for the Republican Party leaders to deny ANY of our citizenry comprehensive and affordable healthcare while they access excellent healthcare, paid for and supported by our citizenry!

If the Republican Party ever "returns" it should bring bipartisan healthcare legislation, which provides comprehensive and affordable healthcare for ALL our citizens. It is not easy to masquerade an extreme credo of neo-laissez-faire economics and neo-federalism dogma as healthcare.

It's easy for the Republican Party to repeatedly (>50Xs) cast stupid votes to repeal Obamacare when they have a responsible president willing to veto their stupidity. Not so much with an uninformed president or as the Kremlin might say a sycophant stooge.

Our "new" alt-white-house and Republican Party intend to keep prescribing a harmful elixir of neo-laissez-faire economic and neo-federalism dogma in lieu of affordable and comprehensive healthcare? Ironically, their convoluted credo is about not providing all our citizenry with affordable and comprehensive healthcare. It's nothing personal just the price of prescribing neo-laissez-faire economics and neo-federalism dogma, which their credo jingoistically explains as "freedom"!

No Secretary Price it does not depend on how you ask, it depends on whether all our citizens will have affordable comprehensive healthcare? Our citizenry does not want repeal of their healthcare coverage or Sunday morning sermons on Obamacare's problems—they want affordable comprehensive healthcare for themselves, their families, and all our citizenry.

We all wish Senator McCain a speedy and compete recovery from his craniotomy to remove a blood clot, including benign tissue pathology. Senator McCain's surgery by doctors affiliated with the élite Mayo Clinic @ Phoenix is a poignant reminder that all of our citizenry must have equal comprehensive and affordable healthcare?

Maybe the billionaires' threat to our congressional representatives that there will be "no cash until action on healthcare" means that without gutting healthcare for our poor (Medicaid) there is no cash for the billionaires' tax break!?

Unsurprisingly, our "new" alt-white-house tells congress to gut healthcare now and replace it later so they can get on with legislation giving the billionaires a tax break. Where is the promise of affordable healthcare for all our citizens without gaps? It turns our that the Better Care [for Billionaires] Reconciliation Act of 2017 is even meaner and draconian for our poor's healthcare than the CBO's initial scoring. The updated CBO scoring estimates a greater gap between government payment caps and healthcare costs in the out years. Our Senate should rename their draconian healthcare legislation the Reconciliation Act of 2017 for Better Care of Billionaires!

What a beautiful bare knuckle brawl between our prostitutes and their whoremasters. A standoff over whether to deliver the f^cking before the cash or the cash before the f^cking?

Maybe our Supreme Court will take the case and abandon its "free speech" cover story for the whoremasters' cash?

UPDATE: The prostitutes and their whoremasters have delayed voting on their tax plan masquerading as healthcare for our citizens! They keep telling our citizens they need "rescuing" from Obamacare and its minimal government mandated healthcare plans and throwing them a lead life ring. But, if Obamacare and its government mandated minimal healthcare plans are better why do they need "rescuing"? Or worse why would our citizens grab a lead life ring, which the prostitutes and their whoremasters are throwing them, calling it a rescue?

Throwing somebody a lead life ring to rescue them from the problem you have created and are exacerbating while telling them you're rescuing them is beyond nefarious!

The Senate "working-draft" healthcare bill is the House healthcare bill with a more sinister spinmeister telling Americans they'll soon be free...by gutting Obamacare!

A "cult leader" couldn't make sense of the majority leader's spin...freedom to have no healthcare, freedom to have higher healthcare costs, freedom to receive limited healthcare based on religious criteria if you're female, freedom to pay higher premiums for preëxisting conditions, freedom to pay higher premium if your a senior, freedom to file bankruptcy when you're unable to pay medical bills...whatever else the senate majority leader's "working-draft" healthcare bill does it does not "free" Americans or America or provide comprehensive affordable healthcare for All Americans!

No wonder the senate majority leader wants to legislate Trumpcare in secrecy, without debate and FAST!

Unbelievably the Republican Senate plan to fix healthcare is to tells Americans that Obamacare is bad and we're going to make it much worse while charging you more, but you'll have freedom! Yeah, freedom to prematurely die because you do not have healthcare or cannot afford it! If that's American freedom, please keep your freedom and provide affordable, comprehensive healthcare for ALL Americans...FAST!

It's a toss-up which is more despicable the House and Senate healthcare proposals or the fact that they'd seriously offer them as healthcare for our citizenry?

...a lot less! These are the taxpayers, which our "new" alt-white-house's budget proposes to help at the price of healthcare coverage for an estimated 23 million of our citizens; higher premiums for insuring citizens with preëxisting conditions; and higher premiums for aging seniors...

...and these are the taxpayers, which our "new" alt-white-house OMB Director Mulvaney asserts are not getting compassion...you cannot make this stuff up!

Telling America that Obamacare is bad does not make the most recently proposed Trumpcare better! Speaker Ryan is beginning to sound like Kellyanne Conway and Sean Spicer. The estimated 23 million citizens, which would lose healthcare under the GOP healthcare proposal might disagree that they are getting "better policy"? Stated differently, a proposal that eliminates healthcare coverage for 23 million of our citizens IS NOT BETTER POLICY!

Secretary Tom Price, we don't want to imagine a healthcare system, we want real affordable, healthcare for ALL our citizenry, which is equal to or better than the healthcare plans given to Congress.

American exceptionalism...eliminating healthcare for a significant portion of our citizenry and charging seniors more does not seem like optimal policy...and cheaper, better, healthcare coverage for all our citizens is nowhere in sight...now that's "making America great again"!?

House Republicans on Trumpcare (03/12/2017): All our citizens will have access to Trumpcare, which they cannot afford but that's the price of freedom and conservative laissez-faire dogma!

CBO and JCT on Trumpcare (scoring 03/13/2017): "...CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law...average premiums for single policyholders in the nongroup market would be 15 percent to 20 percent higher than under current law...Under the legislation, some people [poor and elderly!] would be eligible for smaller subsidies than those under current law, and others would be eligible for larger ones [bet you can't guess who?]...In 2019, the number of uninsured would grow to 16 million people because of further reductions in Medicaid and nongroup coverage..." (read entire CBO scoring report here or if you're a fans of our "new" alt-white-house CBO's fake scoring report)!!!

Sometimes congressional proposals are so absurd you just have to laugh! It's unclear why congress would define "freedom" as a significant number of our citizenry (14 M in 2018!) forgoing adequate healthcare? Or propose illusory healthcare for many of our citizens based on harmful economic dogma?

It's unclear how this legislation will improve healthcare beyond the existing Obamacare? Reducing or eliminating healthcare for significant numbers of our citizenry in pursuit of illusory laissez-faire economic dogma is not a useful or necessary legislative goal. Particularly, if it requires the poor to pay more of the nation's healthcare bill!

A "placeholder" in healthcare legislation is not a better and cheaper Obamacare (aka communist takeover of America) for all our citizens without gaps in coverage. Show us the numbers, healthcare policy provisions, coverage, and assumptions!

President Obama knows how complicated providing healthcare to all our citizenry is and he cobbled together a first plan while continuously being called a socialist and communist. Our "new" alt-white-house doesn't know how complicated providing healthcare to all our citizenry is and must ad hoc a cheaper and better plan while being investigated for coördination and coöperation with the socialists and communists!

The House Republican's healthcare ad nauseam mantra of "repeal and replace" has morphed to a "repeal and redirect" mantra, which would redirect the healthcare benefits of our Affordable Care Act from our poor to our rich! Who could have predicted that!?

Repealing healthcare for our citizenry is at cross-purpose with America's long-term economic growth expectations. These expectations are most easily understood with reference to economic productivity or real gross domestic product (GDP) per hour worked. Absent automation and robots healthy citizens of all color and creed, including immigrants will generate that GDP—the healthier, happier, longer living and productive our citizenry the better!

It's likely that providing healthcare to all our citizenry will add more to our long-term real GDP growth than any other single public-private action and perhaps all public-private actions combined (a close second will likely be mitigating the many negative impacts of the unprecedented magnitudes of our inequality metric measures4)?

Pence would do well to adopt to the objectives of his running mate with respect to healthcare for all our citizenry, "...we're not going to have a two-day period...where there's nothing...it'll be great healthcare for much less money..." and former House Speaker Nancy Pelosi:

President Obama, your being very generous with your "Republican-friends'" cruelly cynical repeal-delay-replace political tactical strategy. Your "Republican-friends" are likely intending to rerun their opposition to Obamacare, which has worked for them so well to date, during the 2018 congressional elections.

One might think your cruelly cynical "Republican-friends" hope to keep the House and gain a filibuster-proof Senate in 2018 so they can simply repeal healthcare (i.e. ignore their delayed promise to replace), without political penalty.

Wonder why our citizenry hold our politicians in such low regard or complete disregard, disdain, and disgust? If our citizenry had to associate with your "Republican-friends" they'd embrace their enemies—oh!, wait they just embraced one...he's now their president-elect!

The opinion is likely to be read as contributing more to the categories of fear, uncertainty and distraction than common sense construction aimed at preserving the historic purpose of our Affordable Care Act (i.e. provide every American citizen with affordable and comprehensive healthcare).

Wow, that didn't take long for our Supreme Court to generate more zaniness—not even a Court opinion.

Just a stay of a lower court decision while the Supremes figure out whether yet another religious organization person can assert that their God forbids them from submitting a government form stating that their God forbids them from providing female employees with reproductive healthcare!

Hey, on the positive side our religious organizations persons aren't dragging women to a public square for shamming, dunking, flogging or killing—how's that for speedily enlightened national progress?

More legal mischief created by the "corporation as person" fallacy3, which glides through the bizarre and sublime in to the zany.

It's
unclear what impact the amazingly narrowly tailored opinion will have
on providing equal healthcare to our women. Health and Human Services
(HHS) and our President should accept the Court's invitation to use
alternative methods to ensure all our women have unimpeded access
to complete reproductive healthcare independent of any entities' public
or private religious beliefs.

The Court's stated
objective of judging a religious practitioner's sincerity independent of
whether their religious beliefs are reasonable or mistaken will no
doubt guarantee more zaniness in future court opinions.

Understandably, some of our "laissez faire" justices seemed to conflate market entry with market function and were puzzled that our government has the ability to compel entry into the healthcare market.

If you are equally puzzled query whether our government has, can and would compel individuals to enter the healthcare system (market) if they were: radioactive; carrier of Ebola or other Class IV pathogen; or even a non Class IV pathogen like tuberculosis? (Justice Breyer pursued this line of questioning)

Now assume our explosive field of biochemistry serendipitously discovers that broccoli can treat any or all of the above illnesses. Then our government can and would compel individuals to enter the food market, too—even the most religious or broccoli phobic of our sitting Supreme Court justices!

On market function it seems useful to note that it's very difficult
or impossible for individual states to establish separate healthcare
markets that operate efficiently—they would need to impermissibly restrict interstate travel or face market collapse as the uninsured seeking healthcare flowed into the state.

A "laissez faire" proponent
will tend to slice the baloney nanoscale thin before acknowledging the obvious, that real world markets can and do regularly fail. Often citing prior market interventions as the reason for current market failure—you need look no further than the recent catastrophic collapse of the mortgage market—the failure was caused by to those seeking to provide affordable housing, according to our laissez faire proponents.

If our states cannot individually construct and operate efficient markets then you simultaneously implicate the commerce clause and delimit the "broccoli conjecture"2 articulated and repeated by some of the justices.

1. Had Florida et al. been states in 1790-91 they no doubt would have filed a federal complaint arguing that our Constitution prohibited the nascent central bank from assuming any Revolutionary War debt!

2. The "broccoli conjecture" guesses that if our federal government requires Americans to form a single risk pool for the purpose of diversify healthcare risks then our Supreme Court is unable to delimit a federal government requirement that Americans purchase broccoli.

Unfortunately, we have learned to accept this type of conjecture from our Sunday school teachers—must we also learn to accept it from our Supreme Court justices?